Fundamentals of Pharmacology. Группа авторов
requires the nurse to:Observe the environment, undertake a clinical examination, gather data and communicateConsult the BNF, observe the patient, perform a clinical examination, gather dataObserve the patient, perform a clinical examination, gather data and communicateUse the skills of observation, calculate risk, perform a clinical examination, gather data and communicate
3 The role of the NMC is to:Regulate hospitals or other healthcare settingsRegulate healthcare assistantsRegulate nurses and midwivesRegulate nurses, midwives and pharmacists
4 How many key clauses are there in the NMC's Code:22242523
5 The registered nurse is required to:Act in the patient's best interestsUndertake accurate drug calculations for a variety of medicationsUphold the values of the professionAll of the above
6 What might be the benefits of medications self‐administered by the patient:Staff have more time for other dutiesThe patient gains more controlThere is reduction in the number of medication errorsThere is less risk of infection
7 Medicine management standards provide healthcare workers with:Legal protectionAn ability to opt out of medicines administrationA framework for safe practice in medicines managementThe opportunity to prescribe controlled drugs
8 Oxygen is:Safe to use in any circumstance and does not require a prescriptionA medical gas and has no side effectsA medical gas and as such should be treated as a medicineOnly used in high‐dependency units and never in a patient's home
9 In order to maintain people's safety, staff have to:Have passed an in‐house course concerning competenceHave the appropriate qualifications, competence, skills and experience to maintain people's safetyBe registered with a regulatory bodyBe skilled in CPR
10 Medicines management is different to medicines optimisation as it:Focuses on outcomes and patients rather than process and systemsFocuses on patients and families as opposed to just the patientIs governed by the health or social care regulatorIt only applies in community settings
11 In order to enable a shared decision about treatment:The healthcare provider's values and beliefs are keyPatients' beliefs and preferences about medicines must be understoodThe professional regulator's Code has to be paramountThe patient must sign a consent form
12 The safe use of medicines is the responsibility of:The pharmacistThe patientThe registered practitionerAll of the above
13 The terms ‘non‐compliance’ or ‘non‐adherence’ have been criticised for:Being sexistSuggesting an unequal, paternalistic relationship between health professionals prescribing medication and their patientsSuggesting an equal, relationship between health professionals prescribing medication and their patientsFailing to address the age of the patient
14 A therapeutic relationship is:A helping relationship based on mutual trust and respectA healing relationshipA curative relationship based on the use of medicinesNone of the above
15 The four core governing principles concerning the safe and secure handling of medicines (Royal Pharmaceutical Society) are:Assess, implement, improve, assureEstablish assurance arrangements, ensure capacity and capability, seek assurance, continually improveEstablish insurance, ensure capacity and capability, seek assurance, continually improveEstablish assurance arrangements, ensure asepsis, seek assurance, continually improveEstablish assurance arrangements, ensure capacity and capability, seek validation, continually improve
Chapter 2 How to use pharmaceutical and prescribing reference guides
Claire Pryor and Annette Hand
Aim
This chapter aims to introduce the reader to commonly used pharmaceutical and prescribing reference guides and their use in practice. Specific focus is placed on the British National Formulary (BNF) and other reference guides used in clinical practice.
Learning outcomes
After reading this chapter, the reader will:
Be aware of the different pharmaceutical and reference guides that may be used in practice
Understand how to navigate the BNF (both in print and electronic formats)
Recognise the different prescribing reference guides available (local and national)
Discuss the benefits of using pharmaceutical and prescribing reference guides in practice
Test your knowledge
1 How many times a year is the print version of the BNF updated?
2 What schedule of controlled drug is Midazolam?
3 What is a General Sales List (GSL) medication?
4 Where will you find national prescribing guidelines for managing chronic constipation in adults?
5 Can whiskey be prescribed on an NHS prescription?
Introduction
The world of medications is vast and learning about them can be daunting for all nursing and healthcare students (as well as registered professionals). The people you care for may have extensive lists of medications you need to be able to review, administer, and consider interactions and monitor the effects of these.
Professional bodies have specific standards of practice in relation to medicines and pharmacological knowledge and this will relate to the practitioner's role. The Nursing and Midwifery (NMC) Code (NMC 2018a) states in Standard 18 that nurses and nursing associates must
Advise on, prescribe, supply, dispense or administer medicines within the limits of your training and competence, the law, our guidance and other relevant policies, guidance and regulations.
(Nursing and Midwifery Council, 2018a)
Further guidance is issued for nursing associates. The NMC stipulates the requirement for nursing associates: as per Section 3:16 of their standards of proficiency, they must:
demonstrate the ability to recognise the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions.
(Nursing and Midwifery Council, 2018b)
In order to fulfil these requirements, healthcare professionals must have a level of pharmaceutical knowledge and an awareness of how to and where to find appropriate information to support practice. In a sea of new products and complex regimens, where can you turn for up‐to‐date, clear and concise information to guide your practice? There are numerous guides, websites, texts and resources that are readily available. Ensuring a robust and evidence‐based selection of these is paramount, but the choice is also personal. Some are web based, some print, and a new evolution of healthcare apps for professionals means that there is a selection for all user preferences.
This chapter aims to introduce you to using pharmaceutical and prescribing reference guides with a specific focus on the BNF and other pharmaceutical reference guides. These guides are vital and valuable resources to draw upon to ensure safe, accountable and evidence‐based care that is matched to the needs and wishes of the people you care for.
Skills in practice
You are a first‐year student on your first placement; with your practice supervisor you are assessing a new patient on admission. They give you a list of medication they take and it has lots of names on it that are new to you. You want to impress your supervisor and find out about them for your next shift. How do you do this? Where do you turn?
Your supervisor suggests you look them up and points you to a paper copy of the BNF. Upon opening it, it appears confusing, full of sections and symbols, and you are unsure how to find the information you need.